Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 30087

AbstractMaterial and MethodsResultsDiscussionConclusionReferencesDOI and Others
Readers' Comments (0) Article in PDF Audio Visual Citation Manager Article Statistics Link to PUBMED Print this Article Send to a Friend
Advertisers Access Statistics Resources

Dr Archana Dambal

"Journal of clinical and diagnostic research is a welcome change in publishing practices. It aims to reach out to the grass-root level researchers who do not lack in experience, clinical material and ideas, but lack in their knowledge in English language and statistics. The journal achieves it's aim by supporting in these exact domains.
It also gives due credit to all research designs like descriptive and qualitative studies while many journals ignore these important study designs. The rigorous review process does not allow any compromise in quality
It is indexed in many indexing agencies and the articles are available under creative commons licence free of cost
The frequency of publication supports many aspiring authors from India and other countries.
It's wide scope welcomes articles across various specialities in medicine. In an era when there is an unscientific insistence on speciality specific research by regulatory bodies in medical education, JCDR supports collaborative research across specialities. I wish the publisher all the best in his future endeavors."



Dr. Archana Dambal
Department of General Medicine,
Belgaum Institute of Medical Sciences,Belgaum, Karnataka,INDIA,
On 30 Nov 2018




Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
For authors, the manuscripts can be uploaded online through an easily navigable portal, on other hand, reviewers appreciate the systematic handling of all manuscripts. The way JCDR has emerged as an effective medium for publishing wide array of observations in Indian context, I wish the editorial team success in their endeavour"



Dr Bhanu K Bhakhri
Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Original article / research
Year : 2011 | Month : April | Volume : 5 | Issue : 2 | Page : 307 - 311

The Incidence of Tinea capitis in a Tertiary Care Rural Hospital - A Study

SEEMA BOSE, SANJEEV G KULKARNI, IRFAAN AKHTER

Rural Medical College, Loni-BK, Ahmednagar (M.S.)

Correspondence Address :
Dr Seema Bose, Professor of Microbiology
Rural Medical College, Loni-BK
Ahmednagar – 413736 (M.S.)
E-mail: drseema11ghosh@gmail.com

Abstract

Tinea capitis continues to contribute to the pathological burden, especially in school children. This study was undertaken to document the clinicomycological pattern of the patients who were infected with Tinea capitis, who attended the dermatology OPD in a rural hospital of Maharashtra and to find out the type of infection from the close contacts of the patients. Hair and skin scrapings were obtained from 79 clinically suspected cases of Tinea capitis over a period of one year. In the suspected contacts, brushes and moistened sterile carpet discs were used to collect the samples. Dermatophytes wereisolated from the samples and were identified by conventional methods. Out of the 79 suspected cases of Tinea capitis, 19(24.05%) were culturepositive. The commonest isolate was Trichophyton mentagrophytes 9(47.36%), followed by Microsporum gypseum, Microsporum canis and Trichophyton rubrum. It was seen more commonly in the 5 – 10 years age group, i.e. 12(63.15%). The male: female ratio was 2.8:1. The seborrhoid type was the commonest clinical type, 9(47.36%). Out of 26(32.91%) close contacts of the patients, 6(7.59%) were culture positive and the isolates were the same as that which were obtained from the patients.

Keywords

Tinea capitis, Trichophyton, Microsporum, Seborrhoid

How to cite this article :

SEEMA BOSE, SANJEEV G KULKARNI, IRFAAN AKHTER. THE INCIDENCE OF TINEA CAPITIS IN A TERTIARY CARE RURAL HOSPITAL - A STUDY. Journal of Clinical and Diagnostic Research [serial online] 2011 April [cited: 2019 Apr 21 ]; 5:307-311. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2011&month=April&volume=5&issue=2&page=307-311&id=1249

Tinea capitis, a dermatophytic infection of the scalp, eyebrows and the eyelashes, continues to contribute to the pathological burden, especially in school going children. The infection includes: a. Dry scaling lesions of the scalp, resembling seborrhoeic dermatitis. b. Black dot appearance, because hairs are broken below the surface. c. Favus which is caused by Trichophyton schoenleinii and is seen sporadically as cup like crusts around the infected hair follicles. d. Deep inflammatory boggy lesions (kerions), often with secondary bacterial infection. The genera Microsporum and Trichophyton are most commonly involved in causing Tinea capitis.(1).

The causative agents of the Tinea infections of the beard and scalp were first described by Remak and Schoenlein and then by Gruby during the 1830s. But for all practical purposes, the history of Tinea and it’s causative organisms .i.e., dermatophytes, started with Sabouraud’s monograph, “Les Teignes” in 1910. His work on school children who were suffering from Tinea capitis was acknowledged at St Louis hospital and it was one of the most important milestones in the history of medical mycology.(2). It is unreliable to depend on the clinical diagnosis alone to identify the cases of Tinea capitis, given the range of the clinical expression and the high numbers of children with mild infections, which are difficult to detect. So, laboratory methods should be used for the diagnosis, whenever possible.

The prevalence of Tinea capitis in a particular area depends upon the environmental conditions, personal hygiene and individual susceptibility. The isolation of different species of dermatophytes also varies from one ecological niche to another, depending on their primary natural habitat.(3).

Aims and objectives
This study was undertaken to document the clinicomycological pattern of the Tinea capitis infection in patients who attended the dermatology outpatients department in a rural hospital of Maharashtra and also to find out similar type of infections in the close contacts of the patients.

Material and Methods

The duration of this prospective study was one year. The total study population was 79, among which 53(67.08%) were patients and 26(32.91%) were close contacts of the patients, usually parents and siblings. The scalp of each patient was thoroughly examined in all areas for the evidence of scaling, crusting, follicular inflammation, hair loss and erythema. The scale scrapings were collected from at least two areas with number 15 sterile surgical blades and approximately 12 hair stumps were pulled out with sterile epilator forceps. Both the hairs and the scales were placed in a sterile petri dishes. Direct microscopy was done with 20% potassium hydroxide (KOH) + 36% dimethyl sulfoxide (DMSO). Cultures were put up on Sabourauds’s dextrose agar with or without cycloheximide and on the dermatophyte test agar medium. The tubes and plates were incubated at 37ºC and 25ºC for four weeks.

The detailed history of the age, sex, predisposing factors, etc of the patients and their close contacts was recorded. The pathogenic fungi were identified by the gross colony morphology and microscopically by lactophenol cotton blue mounts and slide cultures.

Trichophyton rubrum was differentiated from the other Trichophyton species by the urease test and the hair perforation test.(1),(3),(4),(5). Samples of scalps and hairs were also obtained from the close contacts of the patients. These contacts had to have clinically obvious signs of Tinea capitis. The close contacts of the patients, who had recently used a sporicidal shampoo, were excluded from the study. The samples of the scalp and hair from the contacts were obtained by briskly rubbing the scalp with a disposable tooth brush or a sterile carpet disk (6)(7). The patients and contacts were questioned about the presence of any other skin lesion.

Results

In our study, the total number of isolates was 19(24.05%). Trichophyton mentagrophytes was the commonest isolate, [9(47.36%)], followed by Microsporum gypseum [5(26.31%)], Microsporum canis [3(15.78%)] and Trichophyton rubrum [2(10.52%)]. (Table/Fig 1).Tinea capitis was more common in the 5-10 years age group, i.e. 12(63.15%). The male:female ratio was 2.8:1.(Table/Fig 2). Out of the 19 isolates, 17(21.51%) were KOH and culture

positive and 2(2.53%) were KOH negative and culture positive. (Table/Fig 3),(Table/Fig 4). The seborrhoid type was the commonest clinical type,i.e. 9(47.36%), followed by black dot and kerions, 5(26.31%) each. [Table/Figure 5].

Out of 26(32.91%) close contacts of the patients, 6(7.59%) were both KOH and culture positive. None of them were KOH negative and culture positive. Out of 6 culture positive contacts, 3(3.79%) showed the growth of Trichophyton mentagrophytes and 1(1.26%) each showed the growth of Microsporum gypseum, Microsporum canis and Trichophyton rubrum. The same species of dermatophytes were isolated from the patients and their contacts..

Discussion

Tinea capitis is not a reportable disease, but because of its contagious nature, an early diagnosis is important in order to control transmission of the disease. This also prevents possible scarring and permanent hair loss.(5) In our study, the seborrhoeic type was most common clinical presentation [9(47.36%)], followed by the black dot and the kerion type [Table/Figure 5]. Al Samarai A G M also found the highest incidence of the seborrhoid type of Tinea capitis in his study (3). Kumar AG et al also reported a higher incidence of Tinea capitis of the non inflammatory type (8). There was a male predominance in our study, the male: female ratio being 2.8:1(Table/Fig 1)(Table/Fig 2). The higher incidence of the Tinea capitis infection in males may be attributed to the easy implantation of the spores due to short hair and the frequency of sharing combs, brushes, caps, etc.(9)(10). Singal et al reported that the Tinea capitis infection had the same amount of incidence in both males and females. (11). Woodgyer observed that the cases of Tinea capitis which were found in children upto the age of 10 years, showed no predilection for either sex. (12). The relatively increased incidence in our set up might be due to its rural background, where, there was a low standard of health education, over crowding, poor hygiene and close personal and animal contacts(13) (14).

The commonest age group which was affected in our study was the 5–10 years age group i.e. 12(63.15%).(Table/Fig 1)(Table/Fig 2). Similar results were obtained by Grover C et al (15).

There are rarities in the scalp infections in post pubertal teenagers and adults as the changes occur in the composition of themedium chain length fatty acids (MCLFAs) of the sebum (2). 3 of our culture positive patients were in their early teens. 2 patients had curly hairs. Curly hairs are more prone to the infection and this may be due to the difficulty in washing the hair. (3). In our study, 17 (21.5%) cases were both KOH and culture positive and 2 (2.53%) were KOH negative and culture positive (Table/Fig 3).

Trichophyton mentagrophytes was the commonest isolate [9 (47.36%)], followed by Microsporum gypseum (5) (26.31%)], Microsporum canis [3 (15.78%)] and Trichophyton rubrum (5) (26.31%)].(Table/Fig 1).
Trichophyton rubrum is not infrequently involved in the infections with Tinea capitis, but it rarely invades the hair (2). Infections caused by anthropophilic fungi are mostly acquired by direct contact with infected humans. Fomites also play an important role and the infection may even be acquired after aerosolization. (16) We isolated Trichophyton rubrum from one patient and the father of that patient also showed culture positivity for the same. Geophilic fungi such as Microsporum gypseum are usually transmitted form a soil source and can be secondarily transmitted by animals to humans. (16)

We isolated Microsporum gypseum from 5 (26.3%) patients. 3 of them used to work in the fields with their parents. We had 5 cases with Kerion. From 2 of them, we isolated Trichophyton mentagrophytes and from the other 3, we isolated Microsporum canis.4 among them had close contact with cats and dogs. The infections which are acquired from animals are usually inflammatory. Sehgal et al (9) found that animals played a significant role in causing the Tinea capitis infection. Trichophyton violaceum is one of the commonest isolates from patients with Tinea capitis which has been reported by various workers from India and other parts of the world. (17)(18).(19). But we could not isolate Trichophyton violaceum from the cases of Tinea capitis.(Table/Fig 6)(Table/Fig 7) (Table/Fig 8)(Table/Fig 9)(Table/Fig 10)

This shows that the distribution of the various aetiological dermatophytes which cause Tinea capitis varies considerably with respect to the geography and the specific population group. This suggestion was also supported by Chen B K et al. (20) In our study, none of the specimens showed the growth of more than one fungal species. Sidat et al had reported multiple isolates from a single specimen. (21) 6(7.59%) close contacts of the patients were KOH and culture positive for dermatophytes. The species of the dermatophytes which were isolated from the contacts were similar to that of the patients. Isolation of the same species of dermatophytes from the patients and their contacts supported the fact that the inclusion of the close contacts of the patients in this study was useful, as they were likely to be a potential source of infection.

Conclusion

Tinea capitis was not uncommon in our setup. Infected hair serves as a chronic reservoir of infection, which can give rise to repeated mycotic infections of the skin. Some of the species of dermatophytes showed a slower response to the azole derivatives. So, it is important to find out the aetiological agents upto the species level. The physical and psychosocial problems which are associated with Tinea capitis are not to be underestimated.

References

1.
Chander J. Superficial Cutaneous Mycoses, In Section II. Textbook of Medical Mycology 3rd Edition. Mehta Publishers, New Delhi; 2009: 122-146.
2.
Rippon J M. Dermatophytosis and Dermatomycosis, In Chapter 8. Medical Mycology : The Pathogenic Fungi and Pathogenic Actinomycetes. 3rd Edition. W. B Saunders Company, Philadelphia; 1988: 169-275.
3.
Al Samarai AGM. Tinea Capitis among children: Public Health Implication. Journal of Clinical and Diagnostic Researh 2007; Vol I, 476-482.
4.
Betty AF, Daniel FS, Alice SW. Laboratory methods in basic microbiology, In Chapter: 50. Bailey and Scotts Diagnostic Microbiology 12th edition Mosby Elsevier 2007; 629-717.
5.
Faithi HI, AGM Al Samarai. Prevalence of Tinea Capitis among school children in Iraq. Eastern Mediterranean Health Journal 2000; 6: 128-137.
6.
Pomeranz AJ, Sabnis SS, Mc Grath GJ, Easterly NB. Asymptomatic Dermatophyte carriers in households of children with Tinea Capitis. Archives of Paediatrics and Adolescent Medicine 1999; 153: 483-486.
7.
Claire Fuller. Changing face of Tinea Capitis in Europe. Current opinion in Infectious Diseases 2009; 22: 115-118.
8.
Kumar AG, Lakshmi N. Tinea Capitis in Tirupati. Indian Journal of Pathology and Microbiology 1990; 33: 360-363.
9.
Sehgal VN, Saxena AK, Kumari S. Tinea Capitis: A clincoetiologic Correlation. International Journal of Dermatology 1985; 24(2): 116-119.
10.
Reid BJ, Shimkin NB, Blank. Study of Tinea Capitis in Philadelphia using case and control groups. Public Health Report 1986; 83: 497-501.
11.
Singal A, Rawat S, Bhattacharya S, Mohanty S, Barua MC. Clinico- Mycological Profile in North India and response to griseofulvin. Journal of Dermatology 2001; 28: 22-26.
12.
Woodgyer A. Trichophyton tonsurans infections in New Zealand.Mycoses 1993; 3:1 – 15.
13.
Venugopal PV, Venugopal TV. Tinea Capitis in Saudi Arabia. International Journal of Dermatology 1993; 32: 39-40.
14.
Al Fozan AS, Nanda A. Dermatophytosis of children of Kuwait. International Journal of Dermatology 1994; 33: 690-693.
15.
Grover C, Arora P, Manchanda V. Tinea Capitis in Paediatric population: A study from north India. Indian Journal of Dermatology, Venereology and Leprology 2010; 76:527-532.
16.
Arvind A, Padhye and Richard C summerbell, In Part IV. Topley and Wilson’s Microbiology and Microbial Infections 10th Edition. Edward Arnold (Publishers) London; 2005: 220-243.
17.
Kalla G, Begra B, Solanki A, Goyal A, Batra A. Clinicomycological study of Tinea Capitis in desert district of Rajasthan. Indian Journal of Dermatology, Venereology and Leprosy 1995; 61: 342-345.
18.
Jha BN, Garg VK, Agarwal S, Khanal B, Agarwalla A. Tinea Cpitis in eastern Nepal. International Journal of Dermatology 2006; 45: 100-102.
19.
Jehangir M, Hussain I, Khurhid K, Haroon TS. A clinico etiologic Correlation in Tinea Capitis. International Journal of Dermatology 1999; 38: 275-278.
20.
Chen BK, Friedlander SF. Tinea Capitis update: A continuing Conflict with an old adversary. Current opinion pediatrics 2001; 13: 331-335.
21.
Sidat MM, Coreia D, Buene TP. Tinea Capitis among children at one suburban primary school in the city of Maputo, Mozambique. Revista da Sociedade de medicina tropical 2000; 40: 3-5.

DOI and Others

JCDR/2011/1249

JCDR is now Monthly and more widely Indexed .
  • Emerging Sources Citation Index (Web of Science, thomsonreuters)
  • Index Copernicus ICV 2017: 134.54
  • Academic Search Complete Database
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhost
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Google
  • Popline (reproductive health literature)
  • www.omnimedicalsearch.com